RESUMO
Moyamoya disease leads to the formation of stenosis in the cerebrovasculature. A superficial temporal artery to middle cerebral artery (STA-MCA) bypass is an effective treatment for the disease, yet it is usually associated with postoperative cerebral hyperperfusion syndrome (CHS). This study aimed to evaluate cerebral hemodynamic changes immediately after surgery and assess whether a semiquantitative analysis of an intraoperative magnetic resonance perfusion-weighted image (PWI) is useful for predicting postoperative CHS. Fourteen patients who underwent the STA-MCA bypass surgery were included in this study. An atlas-based registration method was employed for studying hemodynamics in different cerebral regions. Pre- versus intraoperative and group-wise comparisons were conducted to evaluate the hemodynamic changes. A postoperative increase in relative cerebral blood flow (CBF) at the terminal MCA territory (P = 0.035) and drop in relative mean-time-transit at the central MCA territory (P = 0.012) were observed in all patients. However, a significant raise in the increasing ratio of relative-CBF at the terminal MCA territory was only found in CHS patients (P = 0.023). The cerebrovascular changes of the patients after revascularization treatment were confirmed. Intraoperative PWI might be helpful in predicting the change in relative-CBF at MCA terminal territory which might indicate a risk of CHS.
Assuntos
Angiografia por Ressonância Magnética , Artéria Cerebral Média/cirurgia , Doença de Moyamoya/cirurgia , Artérias Temporais/cirurgia , Adulto , Encéfalo/irrigação sanguínea , Encéfalo/fisiopatologia , Angiografia Cerebral , Revascularização Cerebral , Circulação Cerebrovascular/fisiologia , Ponte de Artéria Coronária , Feminino , Hemodinâmica , Humanos , Masculino , Pessoa de Meia-Idade , Artéria Cerebral Média/fisiologia , Doença de Moyamoya/diagnóstico por imagem , Doença de Moyamoya/patologia , Complicações Pós-Operatórias , Estudos Prospectivos , Síndrome , Artérias Temporais/fisiologia , Resultado do TratamentoRESUMO
BACKGROUND AND PURPOSE: This study examined the association between poststroke anxiety symptoms (PSA) and frontal lobe infarcts. METHODS: A cohort of 693 patients was recruited. PSA was defined as an anxiety subscale of the Hospital Anxiety and Depression Scale score of 8 or above. The presence and location of infarcts were evaluated with MRI. RESULTS: Compared with the non-PSA group, PSA patients were more likely to have right frontal acute infarcts. Right frontal infarcts remained independent predictors of PSA in the multivariate analysis, with an odds ratio of 4.44 (P=0.002). CONCLUSIONS: The results suggest that right frontal acute infarcts may play a role in the development of PSA.
